The preferred embodiment proposed by this patent claim pertains to an endoscopic surgical blockage to the innervation of prescaral nerve plexus through vaginal approach, particularly referred to a laparascopic surgical blockage to the innervation of hypogastric nerve plexus or prescaral nerve plexus through the abdomen of lower technical difficulty and higher in safety.
Notwithstanding that chronic pelvic floor pain has long been a common issue confronting the gynecological field, which the cause behind chronic pelvic floor pain, except organic mutation, can persist despite no organic mutation ever detected. In clinical practice, hormones may be dispensed as treatment by medication for improving the symptoms, or surgical procedure may be administered in removing the patient""s neural plexus.
Conventional laparatomic neurectomy of hypogastric plexus requires surgically removing the hypogastric plexus, a procedure effective in eliminating the patient""s symptoms of inorganic pain for said hypogastric plexus are behind the symptoms or inorganic pain suffered by the patient; however, such laparatomic neurectomy comes with wider incision to require the patient in longer-hospital stay, and of slower recovery.
To compensate the downfall of extended incision required of conventional laparatomic neurectomy, an abdominal endoscopic blockage to the innervation of prescaral nerve plexus has been proposed, which requires a surgical procedure of inserting an abdominal endoscope below the patient""s navel, locate the hypogastric plexus for surgical removal to minimize the incision and speed up the patient""s recovery.
Nevertheless, the laparascopic neurectomy of hypogastric plexus requires infusing CO2 into the patient""s abdominal cavity in order to have distended abdominal cavity and better visual assessment of the operative field, which is regarded of higher technical difficulty thus more risky, thus can be improved upon.
The main objective of the preferred embodiment proposed by the patent lies offering a solution to the problem described above through a vaginal endoscopic surgical blockage to the innervation of presacral nerve plexus, which pertains to having said vaginal endoscope penetrate the post fornix of vagina to reach the presacral nerve plexus. The vaginal endoscope is used to locate and surgically intervene the presacral never plexus which cause the pelvic floor pain. Since posterior fornix of vagina is located closer to the retroperitoneal space, it is easier to locate presacral nerve plexus by penetrating the post fornix of vagina by the vaginal endoscope for a smaller and shallower incision, thus achieving a dual effect of reduced surgical difficulty and improved safety.
The preferred embodiment proposed by the patent pertains to a vaginal endoscopic surgical blockage to the innervation of presacral nerve plexus, which entails the following procedure,
The patient is prepared in a lithiotomy position or a knee-chest position, and the operation proceeded under proper anesthesia;
Sterilization of operating field is administered to the patient;
The cervix is lifted to expose the post fornix, and the operative vaginal endoscope is inserted through the post fornix of vagina to the retroperitoneal space where the presacral nerve plexus are located. And since the retroperitoneal space is connected beneath the culdesac pouch, thus no penetration to the retroperitoneal space is needed to enter the pelvic cavity.
The vaginal endoscope is used to locate the innervation of presacral nerve plexus, and the surgical tool within the vaginal endoscope is used to intervene the innervation of presacral nerve plexus;
The vaginal endoscope is then retrieved, and a post surgery examination and bleeding treated to conclude the procedure.